Self-reported illness & health status among Gulf War veterans. A population-based study. The Iowa Persian Gulf Study Group

OBJECTIVE: To assess the prevalence of self-reported symptoms
and illnesses among military personnel deployed during the
Persian Gulf War (PGW) and to compare the prevalence of these
conditions with the prevalence among military personnel on
active duty at the same time, but not deployed to the Persian
Gulf (non-PGW).

DESIGN: Cross-sectional telephone interview
survey of PGW and non-PGW military personnel. The study
instrument consisted of validated questions, validated
questionnaires, and investigator-derived questions designed
to assess relevant medical and psychiatric conditions.
SETTING: Population-based sample of military personnel from
STUDY PARTICIPANTS: A total of 4886 study subjects were
randomly selected from 1 of 4 study domains (PGW regular
military, PGW National Guard/Reserve, non-PGW regular
military, and non-PGW National Guard/Reserve), stratifying
for age, sex, race, rank, and branch of military service.
MAIN OUTCOME MEASURES: Self-reported symptoms and symptoms of
medical illnesses and psychiatric conditions.

Overall, 3695 eligible study subjects (76%) and 91% of the
located subjects completed the telephone interview. Compared
with non-PGW military personnel, PGW military personnel
reported a significantly higher prevalence of symptoms of
depression (17.0% vs 10.9%; Cochran-Mantel-Haenszel test
statistic, P<.001), posttraumatic stress disorder (PTSD)
(1.9% vs 0.8%, P=.007), chronic fatigue (1.3% vs 0.3%,
P<.001), cognitive dysfunction (18.7% vs 7.6%, P<.001),
bronchitis (3.7% vs 2.7%, P<.001), asthma (7.2% vs 4.1%,
P=.004), fibromyalgia (19.2% vs 9.6%, P<.001), alcohol abuse
(17.4% vs 12.6%, P=.02), anxiety (4.0% vs 1.8%, P<.001), and
sexual discomfort (respondent, 1.5% vs 1.1%, P=.009;
respondent's female partner, 5.1% vs 2.4%, P<.001).
Assessment of health-related quality of life demonstrated
diminished mental and physical functioning scores for PGW
military personnel. In almost all cases, larger differences
between PGW and non-PGW military personnel were observed in
the National Guard/Reserve comparison. Within the PGW
military study population, compared with veterans in the
regular military, veterans in the National Guard/Reserve only
reported more symptoms of chronic fatigue (2.9% vs 1.0%,
P=.03) and alcohol abuse (19.4% vs 17.0%, P=.004).

CONCLUSIONS: Military personnel who participated in the PGW
have a higher self-reported prevalence of medical and
psychiatric conditions than contemporary military personnel
who were not deployed to the Persian Gulf. These findings
establish the need to further investigate the potential
etiologic, clinical, pathogenic, and public health
implications of the increased prevalence of multiple medical
and psychiatric conditions in populations of military
personnel deployed to the Persian Gulf.

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